title: Chest tube insertion is one important factor leading to intercostal nerve impairment in thoracic surgery.
abstract: OBJECTIVE
  Chest tube insertion seems to be one important factor leading to intercostal nerve impairment. The purpose of this prospective study was to objectively evaluate intercostal nerve damage using current perception threshold testing in association with chest tube insertion.
  
  
  METHODS
  Sixteen patients were enrolled in this study. Intercostal nerve function was assessed with a series of 2000-Hz (Aβ fiber), 250-Hz (Aδ fiber), and 5-Hz (C fiber) stimuli using current perception threshold testing (Neurometer CPT/C(®)). Current perception threshold values at chest tube insertion were measured before surgery, during chest tube insertion and after removal of the chest tube. Intensities of ongoing pain were also assessed using a numeric rating scale (0-10).
  
  
  RESULTS
  Current perception thresholds at each frequency after surgery were significantly higher than before surgery. Numeric rating scale scores for pain were significantly reduced from 3.3 to 1.9 after removal of the chest tube (p = 0.004). The correlation between current perception threshold value at 2000 Hz and intensity of ongoing pain was marginally significant (p = 0.058).
  
  
  CONCLUSIONS
  This is the first study to objectively evaluate intercostal nerve damage at chest tube insertion. The results confirmed that chest tube insertion has clearly deleterious effects on intercostal nerve function.
authors.affiliation: Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan, miyataku@nagasaki-u.ac.jp.
authors.forename: Takuro
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sakai
authors.forename: Naoya
authors.initials: N
authors.lastname: Yamasaki
authors.forename: Tomoshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tagawa
authors.forename: Go
authors.initials: G
authors.lastname: Hatachi
authors.forename: Koichi
authors.initials: K
authors.lastname: Tomoshige
authors.forename: Mariko
authors.initials: M
authors.lastname: Mine
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007367:Intercostal Nerves / Q000293:injuries* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D019616:Thoracic Surgical Procedures